| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
328 |
289 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
60 |
58 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
146 |
137 |
$969.85 |
| 36415 |
Collection of venous blood by venipuncture |
144 |
135 |
$301.41 |
| 80076 |
|
43 |
43 |
$297.36 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
26 |
25 |
$190.58 |
| 84443 |
Thyroid stimulating hormone (TSH) |
12 |
12 |
$174.72 |
| 87430 |
|
13 |
13 |
$170.43 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$151.32 |
| 81000 |
|
47 |
46 |
$147.58 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
29 |
25 |
$107.88 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
21 |
14 |
$50.70 |